Length of stay, readmission, and mortality after primary surgery for pediatric spinal deformities: a 10-year nationwide cohort study

Abstract BACKGROUND CONTEXT Extended length of stay (extLOS) and unplanned readmissions after first time pediatric spinal deformity surgery are a considerable challenge to both the patient health-care system. To our knowledge, only limited number nationwide studies reporting short-term comorbidity with complete follow-up exist. PURPOSE The purpose this study was identify postoperative complications leading extLOS, readmissions, mortality within 90 days surgery. Furthermore, risk factors for readmission. DESIGN Retrospective national cohort study. PATIENT SAMPLE A registry including all patients (≤21 years age) undergoing primary during 2006–2015 (n=1,310). OUTCOME MEASURES Reasons extLOS 90-day as well risk. METHODS Patients were identified by procedure diagnosis codes in Danish National Patient Registry (DNPR). Data on (LOS), retrieved from DNPR. categorized six groups according etiology. readmission collected medical records discharge summaries. RESULTS For 1,310 patients, median LOS 8 (interquartile range 7–9). Etiologies idiopathic (53%), neuromuscular (23%), congenital/structural (9%), spondylolisthesis (7%), Scheuermann kyphosis (5%), syndromic (3%). total 274 (21%) had most common reason pain/mobilization issues but variation between etiologies; (91%), (59%), (44%), (38%), congenital (30%). Pulmonary group (22%). rate 6%; 67% medical, mainly infections unrelated surgical site (23%); 33% 14% required revision Neuromuscular deformity, spondylolisthesis, kyphosis, >9 independent readmission; odds ratio (OR) 4.4 (95% confidence interval: 2.2–9.1, p CONCLUSIONS In cohort, extLOS. is infection site. Readmission related etiology increased focus operated warranted.